{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:59:09Z","timestamp":1785405549395,"version":"3.56.0"},"reference-count":30,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Hearing impairment affects speech-language and academic development, creating substantial lifelong public health and economic burdens. In South Africa, early intervention typically follows either the Listening and Spoken Language\u2013South Africa (LSL-SA) or Traditional Speech-Language Therapy (TSLT) model. Although LSL-SA demonstrates promising outcomes, limited evidence compares its costs with TSLT in low- and middle-income countries (LMICs). Such evidence is needed to inform equitable health financing and disability-inclusion policies.\nAim:\u00a0This study aimed to compare the total and component costs of LSL-SA and TSLT; describe cost distribution across healthcare, education and family domains and identify barriers to accessibility and scalability.\nSetting:\u00a0This study was conducted in South Africa and examined intervention pathways for children with hearing impairment.\nMethods:\u00a0A comparative costing approach was used to estimate expenditures across healthcare, education, and family sectors and compare the economic implications of LSL-SA and TSLT.\nResults:\u00a0Listening and Spoken Language\u2013South Africa incurred higher upfront therapy and rehabilitation costs but achieved superior outcomes, with 78% of children placed in mainstream schools compared with 42% in the TSLT group. The average total cost per child was ZAR 1.08 million for LSL-SA and ZAR 1.02 million for TSLT. Healthcare accounted for 65% of LSL-SA expenditure, whereas TSLT incurred higher education costs (35%) because of greater reliance on special schooling. Overall, LSL-SA demonstrated a more favourable cost-outcome profile despite its higher initial investment.\nConclusion:\u00a0Despite greater upfront investment, LSL-SA produced better educational outcomes and a more favourable cost-outcome profile than TSLT.\nContribution:\u00a0This study provides LMIC-specific economic evidence to inform resource allocation, disability-inclusive policies, and investment in early hearing intervention.<\/jats:p>","DOI":"10.4102\/jphia.v17i1.1735","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T09:47:40Z","timestamp":1783331260000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A descriptive cost comparison of Listening and Spoken Language \u2013 South Africa versus traditional Speech-Language Therapy as therapeutic approaches for deaf and hard-of-hearing children in South Africa"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5700-0528","authenticated-orcid":false,"given":"Aisha","family":"Casoojee","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6220-9606","authenticated-orcid":false,"given":"Katijah","family":"Khoza-Shangase","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref0","unstructured":"World Health Organisation. 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